As of July 1, a Florida bill increases oversight of pharmacy benefit managers and offers some protection for pharmacies. However, the legislation has limited effects on patients and providers, highlighting the need for additional reform.
Ongoing ACR advocacy efforts are working to keep biologic drugs accessible to rheumatology patients, defending the ability of rheumatology practices to use the complex chemotherapy codes for administration of biologic therapies.
Many members of Congress return to their home states and districts in August, making it a great time to engage them in local conversations about healthcare policies and how they affect rheumatology practices and patients.
The ACR and a new Access to Reproductive Health Care Task Force are working to ensure patients with rheumatic disease—particularly women—have access to the medications and treatments they need, including methotrexate, and that rheumatology providers are able to maintain trusting relationships with and advise their patients on all matters relevant to the management of their rheumatic diseases.
If enacted as is, the proposed CY 2023 Medicare Physician Fee Schedule and Quality Payment Program would make significant cuts to reimbursement for evaluation and management services, creating financial instability for providers. On a positive note, it would extend some telehealth flexibilities 151 days beyond the official end of the public health emergency.
Cigna will not move forward with changes to their reimbursement policy for evaluation and management (E/M) codes submitted with modifier 25 as originally scheduled.
All ACR and ARP members are invited to apply to join colleagues and patients in Washington, D.C., on Sept. 19–20 for advocacy training and meetings with legislators to advocate on priority issues that affect rheumatology providers and patients.
As the result of years of coalition work with partners at the AMA, the ACR recently celebrated a major advocacy win when the FTC announced an investigation of PBM business practices. Join or renew your AMA membership before Sept. 1 so the ACR can keep delegate seats to drive action within the AMA.
The ACR is aware of the emerging concerns surrounding access to needed treatments, such as methotrexate, after the recent decision in Dobbs v. Jackson Women’s Health Organization. We are following this issue closely to determine if rheumatologists and rheumatology providers and patients are experiencing any widespread difficulty accessing methotrexate, and if any initial disruptions are…
The growing use of copay accumulator programs, which restrict the application of patient assistance funds toward cost-sharing requirements, hurts patient access to life-changing treatments. This was one topic discussed during the ACR’s Advocacy Leadership Conference in D.C. this May.